Rapid method for quantification of anthocyanidins and anthocyanins in human biological samples

This work was performed with the support of “The Scottish Government's Rural and Environment Science and Analytical Services Division (RESAS),” Scotland, U.K.Peer reviewedPostprin

Brain metastases of neuroendocrine tumor with unknown primary location: Case report

Neuroendocrine tumors are tumors derived from the cells of the neuroendocrine system. The majority of metastases of neuroendocrine tumors occur in liver, lungs and bone. The brain is an uncommon site of metastasize for this type of tumor. The authors of this paper present a case of brain metastases of neuroendocrine tumor with undetermined primary location. The patient, a 35 years-old man, was admitted in our clinic with headache, nausea, vomiting and a mild right facial paresis. Head CT scan and cerebral MRI identified two lesions: one larger lesion with mixed solid and cystic components located in the left basal ganglia and thalamus and a second cystic lesion located deep in the right parietal lobe. All complementary investigations (including thoracic CT scan and whole-body MRI) failed to reveal the primary tumor location. Due to the high vital-risks associated with the open surgical procedure, the patient and his family chose the less invasive procedure of stereotactic biopsy. Postoperatively the patient had no additional neurologic deficits, presenting only the initial mild right central facial paresis. The result of immunohistochemistry examination was cerebral metastases of neuroendocrine tumor. The patient was directed to the Institute of Oncology Fundeni for further investigations and therapeutically management. In conclusion, even if these are rare tumors which rarely metastasize in the brain, the neurosurgeons should take in consideration this pathology when they examine a patient with multiple cerebral lesions with unknown location of primary tumor

Surgical treatment and outcome of cerebral cavernomas: A 10 years’ experience

Cavernous malformations (cavernomas) are congenital low flow angiographic occult vascular lesions with a high tencency to bleeding. The prevalence of cerebral cavernous vascular malformations is estimated to be 0.4% to 0.9%.2,7 CMs in deep locations, including the brainstem, thalamus, and basal ganglia, account for 9% to 35% of all malformations in the brain. We performed a retrospective 10 years study on 130 operated cerebral cavernomas and discussed the clinical status at presentation, the choice and timing of the surgical approach and the short and longterm follow up. The 130 operated cases were divided into a supratentorial 102 (78.46%) group and an infratantorial group 28 (21.53%). The average age at presentation was 43,62 years old (17-76) and there was no sex predominance, male/female = 1,44 (77/53). Only in 14 cases (10.76%) we could find multiple cavernomas which had relatives with multiple cavrnomas, but the familial inheritance was not studied, and only the symptomatic lesion was resected. We divided the outcome results reporting for agroup with superficial respectively profound lesions. The long term follow up for the patients in the profound lesions group showed that 31/37 (83,78%) of patients had a mRS between 0 and 2, and the rest had a poor long term outcome. After surgery there was no clinical deterioration in the superficial lesions group and 22 patients from those who presented in mRS 2 showed neurological improvement on long term follow up, meaning that 82,79% of patients had a 0 or 1 mRS. Microsurgery is the treatment of choice in symptomatic brain cavernomas, total resection being the only curative treatment, capable to prevent further bleeding and to offer an efficient control of seizures.Key words: cavernous malformation, microneurosurgery, seizures

Retrosigmoid approach for a ruptured pontine cavernous malformation, in a 10 years old pacient: Case report

Brainstem cavernous malformations have a high risk of hemorrhage, ranging from 4 to 60%, this risk being even higher in children where larger lesions are encountered. Even small hemorrhages can cause ,severe neurological symptoms because of the high density of cranial nerve nuclei and fiber tracts within the brainstem. The goal of surgical treatment is not only the improvement of neurological symptoms, but also preservation of the patient’s quality of life. We present a case of a 10 years old female pacient who presented after a 5 weeks conservative treatment with right sided weakness and loss of coordination, right hemihipoesthesia, She was diagnosed with a large left pontine cavernous malformation on MRI. The cavernoma was resected using a retrosigmoidian approach , but a small remnant was left, when the surgery had to be stopped due to severe bradicardia. The neurological deficit improved at follow up.The choice of the surgical approach that allows the best exposure of the lesion is mandatory. In this case the lesion was evident on the surface of the brainstem and this facilitated its resection. Traction on the tumor and coagulation near the cranial nerves nuclei should be avoided, but if bradicardia appears the surgery must be stopped.Surgery is the best choice for the patients with symptomatic brainstem cavernomas that present with hemorrhage and neurological deficit, and its objectives should be complete removal and improvement of neurological deficit.&nbsp